Non-Alcoholic Fatty Liver and Fatty Pancreas Diseases Associate with Acute Pancreatitis

Süleyman Ahbab; Ayşe Keskin; Emre Hoca; Esra Ataoğlu; Tuba Selçuk Can; Fatih Türker; Betül Çavuşoğlu

doi:10.7197/cmj.1079443

EN

Non-Alcoholic Fatty Liver and Fatty Pancreas Diseases Associate with Acute Pancreatitis

Abstract

Objective: Fat accumulation in the liver and pancreas are clinical manifestations of metabolic syndrome associated with inflammation. It aimed to investigate the effects of the computed tomography (CT) estimated non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreas disease (NAFPD) on the development of acute pancreatitis in this study. Patients and methods: This retrospective and cross-sectional study consisted of 194 participants admitted to the hospital with an abdominal pain complaint and underwent an abdominal CT scan during the investigation of the differential diagnosis. Medical database records of patients were investigated. Groups were consisted of according to the presence of acute pancreatitis as study and control. Attenuation measurements of the liver and pancreas were determined according to abdominal CT. Results: A statistical significance was observed for the development of acute pancreatitis when patients with normoglycemia were compared to patients with prediabetes and diabetes. Percentages of NAFLD and NAFPD according to the median of CT attenuation difference between pancreas and spleen values were elevated in the study group. A logistic regression model revealed that prediabetes, type 2 diabetes, NAFLD, and NAFPD, according to median value, were risk factors for acute pancreatitis (p<0.001, =0.001, =0.02, and =0.022). Discussion: NAFLD and NAFPD, according to the median value of patients without pancreatitis, were determined as independent risk factors for the development of acute pancreatitis.

Keywords

References

Alberti KG, Zimmet P, Shaw J, IDF Epidemiology Task Force Consensus Group. The metabolic syndrome a new worldwide definition. Lancet 2005; 366: 1059-62
Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract 2014; 2014: 943162, DOI:10.1155/2014/943162.
Yki-Jarvinen H. Non-alcoholic fatty liver diseaseas a cause and consequence of metabolic syndrome. Lancet Diabetes Endocrinol 2014; 2: 901-10.
Contos MJ, Choudhury J, Mills AS, Sanyal AJ. The histologic spectrum of nonalcoholic fatty liver disease. Clin Liver Dis 2004; 8(3): 481–500 10.1016/j.cld.2004.04.013.
Lee JS, Kim SH, Jun DW, et al. Clinical implications of fatty pancreas: correlations between fatty pancreas and metabolic syndrome. World J Gastroenterol 2009; 15: 1869-75.
Rosenblatt R, Mehta A, Snell D, et al. Ultrasonographic nonalcoholic fatty pancreas is associated with advanced fibrosis in NAFLD: A retrospective analysis. Dig Dis Sci 2018; doi:10.1007/s10620-018-5295-x
Lankish PG, Apte M, Banks PA. Acute pancreatitis. Lancet 2015; 4; 386(9988) :85-96. doi:10.1016/S0140-6736(14)60649-8.
Mikolasevic I, Milic S, Orlic L, et al. Metabolic syndrome and acute pancreatitis. Eur J Intern Med 2016; 32:79-83. doi: 10.1016/j.ejim.2016.04.004.

Miko A, Farkas N, Garami A, et al. Preexisting Diabetes Elevates Risk of Local and Systemic Complications in Acute Pancreatitis: Systematic Review and Meta-analysis. Pancreas 2018; 47(8):917-923.
Xu C, Qiao Z, Lu Y, et al. Influence of fatty liver on the severity and clinical outcome in acute pancreatitis. Plos One 2015;10, e0142278.
Mikolasevic I, Orlic L, Poropat G, et al. Nonalcoholic fatty liver and the severity of acute pancreatitis. Eur J Intern Med 2017; 38:73-8.
Lawrence DA, Oliva IB, Israel GM. Detection of hepatic steatosis on contrast-enhanced CT images: diagnostic accuracy of identification of areas of presumed focal fatty sparing. American Journal of Roentgenology 2012; 199(1): 44-7.
Kodama Y, Ng CS, Wu TT, et al. Comparison of CT methods for determining the fat content of the liver. American Journal of Roentgenology 2007; 188(5): 1307-1312.
Kim SY, Kim H, Cho JY, et al. Quantitative assessment of pancreatic fat by using unenhanced CT: pathologic correlation and clinical implications. Radiology 2014; 271(1): 104-12, doi: 10.1148/radiol.13122883.
Smits MM, van Geenen EJ. The clinical significance of pancreatic steatosis. Nat Rev Gastroenterol Hepatol 2011; 8(3):169-177.
Di Ciaula A, Portincasa P. Fat, epigenome, and pancreatic diseases. Interplay and common pathways from a toxic and obesogenic environment. Eur J Intern Med 2014; 25:865–873.
Taguchi M, Kubo T, Yamamoto M, Muramatsu K, Yasunaga H, Horiguchi H, Fujimori K, Matsuda S, Fushimi K, Harada M. Body mass index influences the outcome of acute pancreatitis: an analysis based on the Japanese administrative database. Pancreas 2014; 43:863–866.
Blomgren KB, Sundström A, Steineck G, Wiholm BE. Obesity and treatment of diabetes with glyburide may both be risk factors for acute pancreatitis. Diabetes Care 2002; 25:298–302.
Vidarsdottir H, Möller PH, Vidarsdottir H, Thorarinsdottir H, Björnsson ES. Acute pancreatitis: a prospective study on incidence, etiology, and outcome. Eur J Gastroenterol Hepatol 2013 Sep; 25(9): 1068-75.
Mathur A, Marine M, Lu D, Swartz-Basile DA, Saxena R, Zyromski NJ, Pitt HA. Nonalcoholic fatty pancreas disease. HPB (Oxford) 2007; 9:312–318.
Weng S, Zhou J, Chen X, Sun Y, Mao Z, Chai K. Prevalence and factors associated with nonalcoholic fatty pancreas disease and its severity in China. Medicine 2018; 97(26): e11293. doi:10.1097/MD.0000000000011293.
Rossi A, Fantin F, Zamboni G, Mazzali G, Rinaldi C, et al. Predictors of ectopic fat accumulation in liver and pancreas in obese men and women. Obesity 2011; 19: 1747–1754.
Zyromski NJ, Mathur A, Pitt HA, Lu D, Gripe JT, Walker JJ, Yancey K, Wade TE, Swartz-Basile DA. A murine model of obesity implicates the adipokine milieu in the pathogenesis of severe acute pancreatitis. Am J Physiol Gastrointest Liver Physiol 2008; 295: G552–G558.
Gyllenhammer LE, Alderete TL, Toledo-Corral CM, Weigensberg M, Goran MI. Saturation of subcutaneous adipose tissue expansion and accumulation of ectopic fat associated with metabolic dysfunction during late and post-pubertal growth. Int J Obes (Lond) 2016; 40: 601–606.
Della Corte C, Mosca A, Majo F, Lucidi V, Panera N, Giglioni E, Monti L, Stronati L, Alisi A, Nobili V. Nonalcoholic fatty pancreas disease and Nonalcoholic fatty liver disease: more than ectopic fat. Clin Endocrinol (Oxf) 2015; 83: 656–662.
You L, Zhao W, Hong X, Ma L, Ren X, Shao Q, et al. The Effect of Body Mass Index on Surgical Outcomes in Patients Undergoing Pancreatic Resection: A Systematic Review and Meta-Analysis. Pancreas 2016; 45: 796–805.
House MG, Fong Y, Arnaoutakis DJ, Sharma R, Winston CB, Protic M, et al. Preoperative predictors for complications after pancreaticoduodenectomy: impact of BMI and body fat distribution. J Gastrointest Surg 2008; 12:270–8.
Navina S, Acharya C, DeLany JP, Orlichenko LS, Baty CJ, Shiva SS, et al. Lipotoxicity causes multisystem organ failure and exacerbates acute pancreatitis in obesity. Sci Transl Med 2011; 3:107r.
Acharya C, Cline RA, Jaligama D, Noel P, Delany JP, Bae K, et al. Fibrosis reduces severity of acute-on-chronic pancreatitis in humans. Gastroenterology 2013; 145: 466

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Süleyman Ahbab
0000-0001-9239-9132
Türkiye

Ayşe Keskin
0000-0002-9455-1027
Türkiye

Emre Hoca ^*
0000-0003-4232-7362
Türkiye

Esra Ataoğlu
0000-0002-6559-2575
Türkiye

Tuba Selçuk Can
0000-0002-2388-1715
Türkiye

Fatih Türker
0000-0002-8281-0319
Türkiye

Betül Çavuşoğlu
0000-0002-8041-1904
Türkiye

Publication Date

December 31, 2022

Submission Date

February 28, 2022

Acceptance Date

December 30, 2022

Published in Issue

Year 2022 Volume: 44 Number: 4

DOI

https://doi.org/10.7197/cmj.1079443

IZ

https://izlik.org/JA85JT22GJ

Cite

RIS / Bibtex

AMA

1.Ahbab S, Keskin A, Hoca E, et al. Non-Alcoholic Fatty Liver and Fatty Pancreas Diseases Associate with Acute Pancreatitis. CMJ. 2022;44(4):436-442. doi:10.7197/cmj.1079443

Cited By

Correlation study of fatty pancreas and fatty liver CT manifestations with biochemical parameters in middle-aged and young adult cholecystectomy patients

BMC Gastroenterology

https://doi.org/10.1186/s12876-025-04447-0

Öz

Non-Alcoholic Fatty Liver and Fatty Pancreas Diseases Associate with Acute Pancreatitis

Abstract

Keywords

References

Details

Primary Language

Subjects

Journal Section

Authors

Publication Date

Submission Date

Acceptance Date

Published in Issue

DOI

IZ

Cite

Cited By

Correlation study of fatty pancreas and fatty liver CT manifestations with biochemical parameters in middle-aged and young adult cholecystectomy patients